Individual provider Active NPI

Jonathan Pavicic

  • Physician Assistant
  • Delray Beach, FL
National Provider Identifier
1215518568
Registry record updated Apr 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9114198 Issued in FL
Practice address
1425 S Congress Ave
Delray Beach, FL 33445-6384
Phone
(561) 271-7356
NPI assigned
Apr 19, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA9114198 FL Primary

Addresses

Primary practice location

1425 S Congress Ave
Delray Beach, FL 33445-6384

Mailing address

8081 Tumblestone CT Apt 318
Delray Beach, FL 33446-4442
Phone (561) 603-8951

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210506001816 FL Practitioner - Physician Assistant 7618386475 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
74.32 of 100Reported as group
Quality
41.6
Promoting interoperability
95
Improvement activities
40
Cost
76.98

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Carbon Health Medical Group of Florida PA CurrentSince Dec 12, 2023 Accepting new patients
Carbon Health Medical Group of Florida PA CurrentSince Dec 12, 2023 Accepting new patients

Locations

8931 W Atlantic Blvd
Coral Springs, FL 33071
Phone (754) 225-7033

4825 SW 148th Ave
Davie, FL 33330
Phone (954) 526-7291

915 W 49th St
Hialeah, FL 33012
Phone (305) 200-1225

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1618790400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618790400000",
    "number": "1215518568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8081 TUMBLESTONE CT APT 318",
            "city": "DELRAY BEACH",
            "state": "FL",
            "postal_code": "334464442",
            "telephone_number": "561-603-8951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1425 S CONGRESS AVE",
            "city": "DELRAY BEACH",
            "state": "FL",
            "postal_code": "334456384",
            "telephone_number": "561-271-7356"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAVICIC",
        "first_name": "JONATHAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-19",
        "last_updated": "2021-04-19",
        "certification_date": "2021-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9114198",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Delray Beach, FL

Sources for this page

Verify at the official NPI Registry.